Drug trafficking in the United States is a growing epidemic. In Maryland, heroin has flooded the streets. The crazy thing is, the heroin in Maryland is being mixed with fentanyl (Yes, the common hospice opioid) to amplify the potency of the two drugs. Unfortunately, this powerful combination usually results in death. One would assume that a drug that kills people is a drug that no one would want. However, demand and deaths from this potent combination continue to rise.
Maryland experienced 1,173 fentanyl-related deaths between January and September of 2017 according the Maryland Department of Health. Fentanyl is 50 to 100 times for potent than heroin. Carfentanil, a tranquilizer used on rhinos, is also being mixed with the heroin sold on the streets and was linked to 57 deaths in 2017. Carfentanil is 100 times more potent than fentanyl. It is no mystery that the users of this fentanyl-laced heroin are dying.
Hospices are exempt from a lot of the national crackdown on opioid medications simply because patients that are dying often need higher doses and more powerful opioid medications. Some experts are saying that hospices are not doing enough to prevent family members and hospice staff from stealing hospice medications that have street value, like fentanyl. Since most hospice patients receive care in the comfort of their homes, it can be very difficult if not impossible to monitor where the drugs are ending up and if the patient is the one actually taking them.
Reported cases of medications getting in the wrong hands are popping up all over the United States. Parents are using the painkillers for their child with brain cancer, hospice workers are stealing their patients pills, and even neighbors are stealing painkillers from their neighbor on hospice care. Sources do not claim that the fentanyl supply that is hitting the streets in Maryland is coming directly from hospice, but it is possible that some of the supply is.
According to Melissa Bailey of the Washington Post, "Hospices have largely been exempt from crackdowns in many states on opioid prescriptions because dying people may need high doses of opioids. But as the opioid epidemic continues, some experts say hospices aren’t doing enough to identify families and staff members who might be stealing pills."
What does all this mean for the hospice industry?
Well we can't be certain, but we are afraid it may lead to more regulation and tighter rules governing how hospices purchase, handle, and deliver medications to their patients. Do not be surprised if more regulations hit the hospice industry in the years to come. As the demand on the streets for opioids like fentanyl continue to rise, so does the street value and the incentives to sell these powerful drugs outside of the hospice doors.